Got Breast Pain? Causes, Symptoms, and Treatment

The bad news first. Breast pain (mastalgia) is one of the most common medical complaints among women of child-bearing age (15-40). Of course, women of any age (including transgender women) can experience breast pain. And do. In fact, 70% of women will experience breast pain sometime in their lifetimes. The good news? While seriously uncomfortable and sometimes unsettling, especially if it’s new pain that appears suddenly and is unrelated to a predictable cause (menstruation, injury), breast pain is rarely a sign of something serious. Still, pain by itself can be a debilitating condition, and there’s no reason a person should suffer in silence with breast pain if a probable cause can be identified and a practical prevention or treatment plan can be initiated. So, if you’re experiencing breast pain on the regular, or even if you’ve just had short periods of unexplained pain, keep reading to learn about the most common causes and the most promising preventive measures and treatments for this all-too-common condition.

Cyclical breast pain – causes, prevention, and treatments

Hormonal fluctuations associated with the menstrual cycle are the most common cause of breast pain, especially in women of child-bearing age/premenopausal women. This cyclical breast pain, due to the rise in estrogen and progesterone before your period starts, can cause breasts to swell and become tender. But it shouldn’t cause concern: Cyclical breast pain is not dangerous. If you experience dull, heavy, or aching breast pain, particularly in the upper and outer portions of one or both breasts (most common), that starts during the week leading up to your period and eases up after it begins, you’re likely experiencing this type of pain. Two more points: Most women don’t experience this type of breast pain after menopause, but many pregnant women do develop “cyclical breast pain” during the first trimester as hormone production increases. To some extent, cyclical breast pain is unavoidable. But there are steps you can take that may alleviate some of the pain.

Tips to ease cyclical breast pain:

• Cut down on caffeine
• Eat a low-fat diet
• Reduce salt intake
• Avoid smoking
• Take an over-the-counter pain reliever, such as Advil, Tylenol, or Naproxen
• Ask your healthcare provider if switching birth control methods may help

Non-cyclical breast pain – causes, prevention, and treatments

Breast pain that isn’t related to the menstrual cycle is classified as non-cyclical breast pain. There are a few other important differences between the two types of pain. This type of breast pain, which is more common in menopausal women (40+) who have stopped having periods, is usually localized to one breast and is often described as a sharper, more acute pain with a burning, stabbing, or aching quality.

Cysts

These fluid-filled sacs can develop at any time for any reason and cause localized breast pain. Cysts aren’t dangerous and often go away on their own without medical intervention, but if new lumps suddenly appear in your breast, it’s best to get it evaluated by your healthcare provider. Ultrasound, mammogram, or aspiration (draining fluid from the cyst) can be used to confirm the diagnosis. And the coolest part? Aspirating a cyst not only diagnoses the condition, but also treats it.

Mastitis

Commonly associated with breastfeeding, mastitis is an inflammation of breast tissue caused by an infection. Signs and symptoms? Pain, redness, swelling, and fever. Your provider can prescribe antibiotics to treat the infection and you can take a pain reliever until the infection is under control.

Muscle Strain/Injury

Activities that strain the chest muscles, like playing sports, weight training, and intense workouts, can cause breast pain. You may feel a sharp, shooting pain at the time of injury, but you might not feel any pain until the next day. This type of breast pain can be treated with pain relievers and, in extreme cases, physical therapy. But it can often be prevented by practicing good posture, using proper lifting techniques, and adjusting your exercise routine to limit strain to this group of muscles. Costochondritis, inflammation in the cartilage that connects your ribs to your sternum, is another condition to keep in mind. This is a deeper pain that can feel more intense, especially if it’s on the same side as your heart, but it isn’t a heart attack and usually doesn’t cause any complications beyond discomfort.

Medication Side Effects

Some common medications, such as birth control pills and hormone replacement therapy, may contribute to breast pain. The list is long, but there are several other medications that carry a potential to cause breast pain, including diuretics, antipsychotics, SSRI antidepressants, digitalis, and methyldopa. If you experience breast pain after starting a new medication or suspect your current med might be the culprit, consult your healthcare provider about possible alternative treatments.

Unsupportive Bra

Without good support, ligaments that connect breast tissue to the chest wall can overstretch and cause achy, sore breasts at the end of the day. To prevent this type of pain, make sure your bra fits correctly and offers the support your breasts deserve. If you have large breasts or exercise regularly, a sports bra is a must. Believe it or not, the generally-accepted lifespan of a bra is nine months to a year. So, it might be time to restock. Your breast health is worth it!

Breast Implants

A common cause of pain after breast augmentation surgery (or any type of breast surgery) is capsular contracture, when scar tissue forms and tightens around the implants or incisions. Talk to your healthcare provider if you’ve had breast surgery in the recent past and start feeling new pain.

Cancer

Breast pain by itself usually isn’t a sign of cancer. Inflammatory breast cancer can cause pain, but it’s associated with other signs and symptoms as well, like red, discolored, swollen, or heavy breasts. Skin on the breast may also thicken or dimple. If you experience new breast pain along with any of these symptoms, make an appointment with your provider to get a breast exam as soon as possible.

Besides the preventive measures and treatment options listed above, there are a few other things you can try if you are experiencing non-cyclical breast pain.

Tips to ease non-cyclical breast pain:

• If your breast pain is severe, ask your provider about Danazol or Tamoxifen. Since these are prescription medications with potential side effects, it’s important to weigh cost and benefit of these drugs carefully.
• Taking vitamin E supplements
• Using evening primrose oil
• Applying warm compresses to the affected area
• Begin a stress management practice, like yoga or meditation, to reduce stress and tension

When to seek medical attention for breast pain

While breast pain causes significant discomfort, it’s usually not a sign of a serious medical condition. There are instances, however, when seeking medical attention is necessary. If you’re concerned about your breast health or develop any of these symptoms, make an appointment with your provider to get an examination.

• Persistent breast pain that doesn’t go away after a couple menstrual cycles or continues after menopause
• Sudden, severe breast pain with no apparent cause
• Changes in breast shape, size, or appearance
• Breast pain that worsens over time, interferes with daily activities, or wakes you up from sleep